Audit: Some Medicaid benefits in Minnesota are going to the wrong people

December 14, 2018 06:17 PM

An audit of Minnesota's version of the federal Medicaid program found benefits were improperly going to people who made too much money and some who moved out of state.

The Office of the Legislative Auditor released the report Friday after auditors examined whether people enrolled in Medical Assistance were eligible to receive benefits under the program in 2017.

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The report found the Minnesota Department of Human Services "generally complied" when it comes to making sure people who receive Medical Assistance are eligible.

However, the audit also discovered not everybody enrolled in the program met the requirements.

For example, auditors say in 15 percent of the cases they examined, the people receiving Medical Assistance exceeded income limits.

According to the audit, several people made nearly double the maximum allowed under federal law yet still qualified for benefits.

"That 15 percent is huge when you talk about billions of dollars being spent in human services," said Sen. Michelle Benson, chair of the Health and Human Services Finance and Policy committee in the Senate. "If someone is making too much money they shouldn't be in our program."

The audit also found two dozen people who moved out of state, which should have disqualified them from the program, still received Medical Assistance.

In one case, auditors say DHS provided Medical Assistance for someone incarcerated, which should have made them ineligible.

In response to the audit, DHS Commissioner Emily Piper says the agency is working with Minnesota IT Services (MNIT) to improve its system to better identify eligibility issues.

Piper's response also indicated DHS is working to reduce worker error through training.

"I don't have confidence it will be resolved," said Benson. "I have confidence it can get better with the right leadership"

DHS released a separate statement to 5 EYEWITNESS NEWS regarding the audit:

“We are pleased this report found we correctly determined eligibility for adults without children in Medical Assistance. Three reports from the Legislative Auditor this year have found that we are determining eligibility correctly for public health care programs, a significant improvement from past audits. Our priority is to ensure that qualifying Minnesotans have access to the health care coverage they need.”